10/16/2007 05:20 pm ET | Updated Nov 17, 2011

Discounted Health Care For Healthier People?

I had a new patient this morning who was 80 years old and came in for acupuncture treatment for a common neuromuscular problem. I Expected to take a long and complicated history from someone his age. I was both surprised and delighted, as we ran through his "review of systems," that he had basically no medical history, and unlike many patients his age, is on no medication at all.

Everyone once in a while, when discouraged and overwhelmed by how complicated every case I get is, even in very young people, I find myself shouting...."just give me a simple tennis elbow." Well, here sitting in front of me this morning, was the equivalent of a simple tennis elbow, though, from an acupuncture/energy medicine point of view, every tennis elbow may be a bit different.

At the end of the session, I told him that I was going to give him a discount on the price of my usual diagnostic intake and treatment, because it had been so short and sweet and uncomplicated, and I thought people should be rewarded for making the effort to live healthy lives and being lucky enough, but also committed enough, to maximize health throughout life. His good health makes my job easier, and if you multiply that by 300 or so million patients, preventative medicine is looking even better than it always has.

He loved this idea...and the discount, and began to tell me the family story. His parents, immigrants who didn't speak English his whole life, were very poor, and during The Great Depression his dad didn't work for 2 years. But, he said "we had a cow and a pig and chickens and fruit trees and a big vegetable garden. We always ate well. That's where my parents put their energy, and we never wasted anything!" My Mom used to say: "Some people put it on their back!", meaning that with limited means, some people gave priority to dressing well to seem OK in hard times. This expression hit a chord with me, as I often find myself thinking that these days, many people fill up on foods that are well below code for constructing a healthy human body, but then deck themselves out in the finest threads they can afford. I hope that as healthy food choices become more available, even for on-the- move, get-it-to-go types, that more people will "put it on their face"....a glow of health and vitality, that is, as they give greater priority to eating healthier food .

For my elderly patient and his family, it was good, clean homegrown, and of course, local, food. To this day, he still grows most of his own vegetables, and right now, like many people in my neighborhood, he can't keep up with all the food coming out of his backyard . Such a problem! It's been a bumper year for every kind of fruit and for most kinds of vegetables. The apple crop throughout the Hudson Valley is abundant and offering up huge volume and variety. I marvel daily at the volume of vegetables in my backyard and feel gratitude and awe that right here in New England we have such lush fertility and a cornucopia of food resources.

Awhile back, I read about a research project which had shown that about half of the food prepared in America is wasted on any given day. I think of my patient's comment that "we never wasted anything." Right now, because people don't have time to deal with them, thousands of apples are rotting on the ground in the area where I live. This is true for lots of other produce too. People who are too busy to have the time to cook, juice, dry or otherwise process all this food, will go out later and buy inferior quality foods, many of which will be shipped in from thousands of miles away. I read in a history book that in colonial times, there was a cider mill set up in the center of many New England towns. Good cider, good work and good community. Not impossible today, and not impossible in an urban environment.

I mention this because it seems related to my elderly new patient staying healthy his whole life at least in part because he started out eating healthy, and has remained in a good relationship with food. This relationship has included not only eating it, but growing it, tending it, starting seedlings in the spring and canning in the fall, and working outside every day to make sure it's all still happening. By being outside, he gets plenty of Vitamin D, something we all need for health, and which is deficient in epidemic numbers in our current, inside-working, primarily urban population. As there are expanded options for urban community gardens and memberships in Community Supported Agriculture projects which encourage weekend visits and work, it becomes truly possible for urbanites to get more involved with their own food producing. A good friend of mine is planning to engineer a roof top garden on his Manhattan brownstone, which will produce a lot of food.....with the added advantage of making his building more energy efficient.

My eighty year old patient was a powerful living reminder that long-lived health is possible. The inspiration of this man will stay with me as I continue to urge that we live healthy from the beginning, balancing our stresses with simple work and pleasures, and, to be very practical, taking advantage of the growing number of work-site contractual arrangements wherein people are rewarded financially, in health care costs, for making healthier life choices. Employers and policy makers also have to work to create jobs and working conditions which actually do reduce stress and promote health. If we really stretch our thinking, we can think of much of our current expensive disease care system as a kind of waste because ultimately, much of it was preventable. Diabetes Type II is one disease which costs untold billions of dollars to treat and is largely preventable, particularly in younger patients. On the other hand, I recognize that many people fall prey to truly catastrophic illnesses, accidents and traumas that were not preventable and for which they need excellent care which does not bankrupt them. In the long run though, more emphasis on prevention would mean less need for catastrophic care down the road.

Thirteen years ago I was diagnosed with breast cancer that had spread to nearby lymph nodes. Saying no to conventional oncology, I have been privileged but also dedicated, to taking care of myself with natural medicines (mostly out of my garden) ever since, and have not cost my health insurance company one cent in cancer related health costs in all those 13 years. Wouldn't you think they'd be knocking down my door to find out what I've been doing....and then possibly discounting my health care insurance premium?